Healthcare Provider Downloads & Resources

Access a comprehensive offering of the most common healthcare provider forms, lists and manuals.

Accessible formats are available upon request to Human Resources.

Provider Registration Declaration Form
To begin the registration process with Express Scripts Canada as a pharmacy provider or to change any personal, office or banking information, please complete and submit the Provider Registration Declaration Form.
Pharmacy Provider Manual
Consult the manual for more information on submitting pharmacy claims.
Drug Recall Protocol
The communication highlights protocols pharmacy providers are to follow in responding to a drug recall.
Claim Form for drugs over $9,999.99
Please complete, print and submit this form for drug claims over $9,999.99.
Pseudo DINs
Consult a list of pseudo DINs that correspond to the chemicals used for compounding
Units of Measure Updates (Package Size)
Pharmacy Provider Contacts
IN Service Newsletter July 2019 (Rest of Canada)
Group User ID Request Form for Online Statements
Frequent Dispensing Form
Cognitive Service Fee Claims (Step Therapy Modules)
Step Therapy Drug List

Dental Hygienist Provider Enrolment Form
To begin the registration process with Express Scripts Canada as a dental hygienist, please complete and submit this form.
Denturist Provider Enrolment Form
To begin the registration process with Express Scripts Canada as a denturist, please complete and submit this form.
Dental Modification Form
For any personal, office or banking changes, please complete and submit the dental modification form.
Group User ID Request Form for Online Statements
To view statements for multiple professionals in one account, please complete and submit the Dental Group User ID Request Form.

Sample Maintenance Medications List
Not sure if your medication is considered maintenance? Check here for a sample list of our maintenance medications.